Please complete the enrolment form below before your first visit to the Northern Arena Supervised Play Area to ensure we know everything
that needs to be known about your child.
*All fields are required
*Primary Caregiver Full Name:
*Primary Caregiver Phone Contact:
*Alternative Caregiver Full Name:
*Alternative Caregiver Phone Contact:
*Emergency Contact Name 1:
*Emergency Contact Number 1:
*Emergency Contact Name 2:
*Emergency Contact Number 2:
*Childs' Full Name:
*Name child is known as:
*Childs' Date of Birth:
*Is your child immunised?
If yes please bring a copy in on your first vist.
*Does your child have any allergies?
If yes, please bring a copy of your action plan on your first visit.
*Does your child have any special requirement(s), including illness or medication?
If YES please give details.
Please specify any other person(s) who CAN pick up your child
Please specify any person(s) who CANNOT pick up your child
*Are there any custodial arrangements concerning your child?
If YES please give details of any custodial arrangements or court orders (a copy of any court order is required).
Please tick check box if you give permission for your child to be...
*Removed from the Supervised Play Area for emergency:
Please read our policies and regulations carefully before booking or using our Limited Attendance Supervised Play Area.
Northern Arena Studio Two, 8 Polarity Rise, Silverdale
Hours of Operation – MONDAY TO FRIDAY
You must complete an enrolment form before your first booking. We also need to take a copy of your child’s immunisation record,
although we do take children who have not been immunized. The information gathered about your child will be kept in the
strictest confidence. Please let Louise know if you change contact details so that we can keep your details current.
Bookings can be made online through the Northern Arena Website. Phone bookings for the day can be made after 8am by calling
reception on 09 421 9700.
Payment for the bookings is to be made at reception before your session.
Cancelations must be made by 7am the day of your booking to avoid being charged for the session.
Please phone reception on 09 421 9700 to cancel.
If there are no spaces available online for the session you would like to book, please fill in a waitlist and we will call
as soon as a space becomes available and endeavour to give you as much notice as possible so that you can get in and workout.
Children who take medication on a regular basis must have
a signed medication action plan which allows us to administer this medication, such as ventolin inhalers. No medication should
be left in children’s bags.
We are committed to trying to eliminate child illness within Northern Arena. We ask if your child has any of the following
symptoms you keep them at home until they have cleared:
Please do not be offended if you are denied access to the centre or you are called back during your workout if your child becomes
distressed. We are only preventing the spread of illness amongst the other children and staff.
Sign In / Sign Out
The centre has a daily register where you sign your child/ren in and out please make sure you remember to do this!
Under no circumstances can you leave Northern Arena whilst your child is in the centre. You may only utilise the gym, physio,
café, swim fit and group fitness classes.
Please provide a change of clothing and feeders if required. Wet wipes and disposable nappies must be provided for your child.
Please provide a named healthy snack, e.g. fruit, sandwich, raisins, cheese etc… and a drink for your child.
Due to some children’s allergies we are a nut free zone.
All of these items should be kept in your child’s named Bag.
Settling Children In
Please talk to staff regarding settling in requirements for your child. Each child will have their own settling needs and it
is important that staff can plan with parents to meet these.
Disposable Changing and Toileting
Please ensure that when you leave your child at the childcare they are wearing a clean dry disposable. If you specifically
wish your child to be changed during their time with us please advise staff of this by writing on the whiteboard provided,
along with the approximate time. Staff will make regular disposable checks, but unless your child is obviously wet or soiled
and you have not written your child’s requirements on the whiteboard, staff will not change your child’s disposable. If
you are changing your child at the childcare please use the change mat provided, not the floor. If your child is toilet
training, please follow the above procedure and tell a staff member of your child’s toileting needs. If you do forget your
disposables, they can be purchased at reception for $2.
Please do not attempt to return to the childcare after the alarm has sounded. After you have evacuated we will meet you in
the assembly area in the Northern Arena Car Park. In the event of an earthquake, staff will assist children to drop and
cover and attempt to keep children calm, begin any first aid and wait for help to arrive.
*Please tick check box to confirm you have read and understood the policies & regulations set out above
*Enter your full name to declare that all the information on this enrolment form is correct:
Please enter the above captcha
© copyright 2016 by Northern Arena | All rights reserved | Phone: 09 421 9700 |
firstname.lastname@example.org | 8 Polarity Rise, Silverdale | SEO NZ by Clickthrough